Abstract

Objective: Long-term antidepressant drug exposure may regulate its target molecule — the serotonin transporter (SERT). This effect could be related to an individual’s genotype for an SERT promoter polymorphism (human serotonin transporter coding [5-HTTLPR]). We aimed to determine the effects of fluoxetine exposure on human platelet SERT levels.Method: We harvested platelet samples from 21 healthy control subjects. The platelets were maintained alive ex vivo for 24 hours while being treated with 0.1 mM fluoxetine or vehicle. The effects on SERT immunoreactivity (IR) were then compared. Each individual’s SERT promoter genotype was also determined to evaluate whether fluoxetine effects on SERT were related to genotype.Results: Fluoxetine exposure replicably altered SERT IR within individuals. Both the magnitude and the direction of effect were related to a person’s SERT genotype. People who were homozygous for the short gene (SS) displayed decreased SERT IR, whereas those who were homozygous for the long gene (LL) demonstrated increased SERT IR. A mechanistic experiment suggested that some individuals with the LL genotype might experience increased conversion of complexed SERT to primary SERT during treatment.Conclusions: These preliminary results suggest that antidepressant effects after longer-term use may include changes in SERT expression levels and that the type and degree of effect may be related to the 5-HTTLPR polymorphism.

Acknowledgements: This work was supported by a VA Merit Award and National Institutes of Health award DA15509.

Competing interests: None declared.

Contributors: Dr. Little designed the study. All authors acquired the data, which Drs. Little and Cook analyzed. Dr. Little wrote the article. All authors critically reviewed the article and gave final approval for its publication.